TeamSTEPPS and Patient Safety

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TeamSTEPPS Method and Patient Safety

TeamSTEPPS is a set of teamwork tools based on evidence that helps to incorporate teamwork principles into healthcare delivery. TeamSTEPPS optimizes patient safety by improving communication skills and teamwork among healthcare professionals. More information on the topic has been presented below.

TEAMSTEPPS METHOD

  • TeamSTEPPS stands for Team Strategies and Tools to Enhance Performance and Patient Safety.
  • It is a set of multiple evidence-based teamwork tools that optimize patient safety by improving communication skills and teamwork among healthcare professionals.
  • The main aim of the TeamSTEPPS method is to remove the "potential barriers to quality and safety by developing skills that promote team situational awareness, clarify roles and responsibilities, resolve conflicts, and improve information sharing."
  • The first phase of the TeamSTEPPS process consists of doing a pre-training assessment in which the training need for the organization is assessed. Specific tools used are a site assessment tool and flowcharts (to map how processes contribute to issues in the area of patient safety).
  • The second phase consists of planning, training, and implementation of a TeamSTEPP initiative customized to the organization. In this phase, tools such as implementation plans and communication plans are used, and training such as Train-the-Trainer, TeamSTEPP fundamentals, and TeamSTEPP essentials are given using multimedia course materials.
  • In the third phase, "improvements in teamwork performance, clinical processes, and outcomes resulting from the TeamSTEPPS initiative" are sustained. Methods such as feedback and coaching are used.

TEAMSTEPPS CURRICULUM

  • According to AHRQ, the curriculum of TeamSTEPPS is a comprehensive multimedia kit that is very easy to use.
  • The curriculum contains "fundamental modules in text and presentation format; a pocket guide that corresponds with the essentials version of the course; video vignettes to illustrate key concepts; and workshop materials on change management, coaching, and implementation."
  • The curriculum of TeamSTEPPS varies with the version of the tool. The different versions of TeamSTEPPS include TeamSTEPPS® 2.0, TeamSTEPPS® for Office-Based Care Version, TeamSTEPPS® Long-Term Care Version, and more.

TEAMSTEPPS® 2.0 CURRICULUM

  • The curriculum for this version consists of three main components. They are essentials course, fundamentals, and supplemental.
  • The curriculum also contains an overview video that explains the processes involved.
  • The additional materials of the curriculum include the TeamSTEPPS Pocket Guide, Course Management Guide, video training tools, measurement tools, acknowledgments, printable components, and specialty scenarios.
  • More details on the curriculum can be accessed here.

TEAMSTEPPS® FOR OFFICE-BASED CARE VERSION CURRICULUM

  • The curriculum for this version can be accessed in three different versions. The three versions of the course are classroom course, self-paced course, and hybrid course.
  • The classroom version includes all the learning materials in the form of a presentation (PowerPoint slides). The presentation includes videos, exercises, an instruction guide, and other training materials.
  • The hybrid version includes all the "material delivered using both classroom and recorded PowerPoint slides. This version is useful when working with individuals across multiple locations."
  • The self-paced version houses the TeamSTEPPS Office-Based Care modules.

TEAMSTEPPS® LONG-TERM CARE VERSION CURRICULUM

  • The curriculum includes multiple portions, such as introduction, navigation, using and customizing the materials, and creating your own instructor manual.
  • The introduction section provides information on the training materials, modules, videos, team structure, and more.
  • The navigation section helps the trainees to navigate through different courses, modules, topics, and parts of the curriculum.
  • According to AHRQ, "to facilitate the customization of the materials, this curriculum includes both print friendly materials as well as source files for aspects of the curriculum that one may wish to modify to fit their needs."
  • Using this curriculum, a trainee can also create their own instruction manual.
  • More details on the curriculum can be accessed here.

ACADEMIC ARTICLES SHOWING THE IMPACT OF TEAMSTEPPS ON PATIENT SAFETY

ARTICLE 1

  • Title of the article: University of Florida Health Center Improves Teamwork Among Staff and Health Outcomes in Diabetes Patients Using TeamSTEPPS
  • Published date: March 2019
  • Objective: The objective of this academic article was to study and show how the University of Florida Health Center improved the teamwork among its staff and optimized patient safety among diabetes patients using TeamSTEPPS.

RESULTS OF THE STUDY:

  • After using TeamSTEPPS, the teamwork and communication of the University of Florida Health Center improved rapidly. The tool also improved patient safety and outcomes.
  • After their Archer team took the TeamSTEPPS training and started using the knowledge, "53 percent of patients with diabetes had reduced blood sugar levels, and 33 percent of patients reduced their severity of depression."
  • Among the 53% of patients mentioned above, 54% maintained the reduction over a one-year period.

ARTICLE 2

  • Title of the article: TeamSTEPPS® Helps St. Louis Hospital Keep C-Section Rate Low
  • Published date: June 2019
  • Objective: The objective of the article was to study and show how TeamSTEPPS helped St. Mary's Hospital in St. Louis to keep the rate of C-section low and ensure patient safety.

RESULTS OF THE STUDY:

  • St. Mary's Hospital in St. Louis performs about "3,400 deliveries a year in 13 labor rooms, two operating rooms, and additional high-risk pregnancy beds."
  • After the staff at the hospital took the TeamSTEPPS training, they were able to reduce "the Cesarean section (C-section) rate for low-risk, first-time mothers to 12 percent."
  • With the help of TeamSTEPPS, "about 75% of women who have had C-sections for their first deliveries are able to successfully deliver subsequent children vaginally." The rate is inclusive of women who have had multiple C-sections.

ARTICLE 3

  • Title of the article: Kaiser Permanente Facilities Use TeamSTEPPS To Improve Obstetrics and Other Patient Care
  • Published date: March 2018
  • Objective: The objective of the article was to study and show how the Kaiser Permanente Facilities in California used TeamSTEPPS to improve obstetrics and patient safety.

RESULTS OF THE STUDY:

  • Kaiser provided the TeamSTEPPS training to its staff at a skilled nursing facility and 16 other medical centers across the state.
  • After the staff of Kaiser Permanente took the TeamSTEPPS training, they were able to reduce the labor-inducing drugs' dosage by approximately 15%, "without increasing C-section rates, from 2015 to 2017."
  • Due to the lesser dosage of labor-inducing drugs, they were able to ensure the safety of pregnant women and their respective children.

ARTICLE 4

  • Title of the article: TeamSTEPPS Helps Arizona Hospital Reduce Emergency Department Wait Times
  • Published date: May 2017
  • Objective: The objective of the article was to study and show how the Banner Payson Regional Medical Center in Arizona reduced the emergency department wait times using TeamSTEPPS.

RESULTS OF THE STUDY:

  • Before April 2015, the patients at the hospital had to wait for an average of 89 minutes for treatment at the emergency department.
  • Thereafter, the hospital provided the TeamSTEPPS training to its staff. By April 2016, the hospital reduced the average wait time for treatment at the emergency department from 89 minutes to only 18 minutes.
  • In only one year, the hospital was able to increase patient safety by a huge margin.

ARTICLE 5

  • Title of the article: Kimbrough Ambulatory Care Center Uses TeamSTEPPS To Boost Patient Safety
  • Published date: August 2016
  • Objective: The objective of the article was to study and show how the Kimbrough Ambulatory Care Center used TeamSTEPPS to boost and optimize patient safety.

RESULTS OF THE STUDY:

  • After providing the TeamSTEPPS training to their staff, Kimbrough Ambulatory Care Center was able to gain a 12% improvement in three different areas by 2015.
  • By 2015, the care center saw a 12% improvement in the staff's ability to reevaluate patient safety and care goals, anticipate each other's needs effectively, and monitor each other's performance.

RESEARCH STRATEGY

We started the research by searching for direct information on TeamSTEPPS and its curriculum. We searched across the official website of AHRQ. AHRQ is the agency that developed TeamSTEPPS. From there, we were able to get the required information. Thereafter, we searched for case studies and academic papers that show the impact of the TeamSTEPPS method on patient safety on the same website. We were able to find a mix of qualitative and quantitative academic papers that could be useful for this research. We selected the academic papers that provided quantitative information on the topic and were published within the past five years. In this way, we were able to select five academic articles that provided quantitative information on the impact of the TeamSTEPPS method on patient safety.
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Teamwork and Communication Skills Among Healthcare Professionals

Four studies/report that indicate how improving teamwork and communication skills among healthcare professionals contributes to increased patient safety include the Effective Communication and Teamwork Improve Patient Safety report, a survey carried out by the Neonatal Intensive Care Unit (NICU), the 'CULTURE OF SAFETY' report by The AHA’s Health Research & Educational Trust (HRET), the Patient and Family Engagement (PFE) survey by Baptist Medical Center Attala, and the report on Kimbrough Ambulatory Care Center's use of TeamSTEPPS to boost patient safety.

TEAMWORK AND COMMUNICATION SKILLS AMONG HEALTHCARE PROFESSIONALS

Effective Communication and Teamwork Improve Patient Safety

  • This survey was carried out at the Neonatal Intensive Care Unit (NICU), a unit that is complex and has a high stress environment.
  • Prior to the test, staff where at risk of not reporting ethical issues due to fear of retaliation, which affected the safety culture and clinical outcomes of the organization.
  • The TeamSTEPPS curriculum, a model designed for health care providers to improve patient safety through effective communication and teamwork skills, along with the HWE measurement tool, were implemented at NICU.
  • The main communication and teamwork skills that were used include leadership, high reliability and the culture of safety, and moral courage and empowerment.
  • The project results revealed that effective communication and staff engagement led to reinforced safety practices that resulted in improved patient care.

'CULTURE OF SAFETY' by The AHA’s Health Research & Educational Trust (HRET)

  • The 'change package' was created for hospitals that participated in the Hospital Improvement Innovation Network (HIIN) project led by the Centers for Medicare & Medicaid Services (CMS) and Partnership for Patients (PFP).
  • It includes a list of strategies, specific actionable items, and change concepts that hospitals can adopt for the benefit of improving the patient quality of life and care.
  • Some communication strategies that were implemented included committing and communicating the priority of patient and workforce safety, fostering a culture of trust, reporting and learning, and building a work environment that enables staff to provide safe and quality care to patients.
  • The package revealed that the implementation and achievement of a safety culture that fosters patient safety with worker safety requires attitudes, beliefs and behaviors changes.
  • Also, "leadership and employee commitment are the hallmark of a true safety culture where safety is an integral part of daily operations".
  • When this is appropriately carried out, it can lead to reduced rate of worker harm events.

PATIENT AND FAMILY ENGAGEMENT (PFE), Baptist Medical Center Attala.

  • A research conducted by the Baptist Medical Center Attala shows a relationship between increased patient and family engagement and fewer adverse events.
  • According to Baptist Medical Center Attala, reduced adverse events can be realized through improved teamwork and communication among medical personnel and by increasing communication between family/patient and staff.
  • The research was done as a request to improve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores above their respective state and national averages.
  • Some effective communication strategies that were implemented included appointing team members and training them on best ways to approach patients, to use key terminology, and the details of HCAHPS surveys. Leadership rounding hours were also set to handle any complaints, praises, or variances that came up.
  • As a result of the implementation of the Patient and Family Engagement model, the hospital's overall HCAHPS scores increased by 5.73 points and a p-value of 0.5013.

Kimbrough Ambulatory Care Center Uses TeamSTEPPS To Boost Patient Safety

  • Kimbrough Ambulatory Care Center at Fort George C. Meade in Maryland adopted the TeamSTEPPS program to train its 650-member workforce. As a result, employee teamwork at the care center increased by 12%.
  • One major communication tool used was the "brief, huddle, and debrief," in which medical staff members meet briefly at the beginning of work shift to talk about a patient’s condition and again at the shift's end, to recap the patient’s condition and a way forward.
  • The training lead to improved staff cohesion and, in turn, teamwork towards patient care and safety.
  • As a result, Kimbrough was recognized by The Joint Commission in 2016 for reaching a high patient safety and quality of care standards.


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